Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/60848.2380
P. Mittal, S. Firoz, Digvijay Ghangas, S. Bhatt
Introduction: Perinatal asphyxia is very common in developing countries. Coagulopathy occurs as a part of spectrum of multiorgan dysfunction following hypoxic insult. In asphyxiated neonate, bleeding due to coagulation abnormality is common and potentially life threatening. There are very few studies done on coagulation profile with perinatal asphyxia in last few decades. Aim: To evaluate the coagulation profile in neonates with hypoxic ischaemic encephalopathy in a tertiary care center, Agra. Materials and Methods: This was a prospective clinical study undertaken in Neonatal Intensive Care Unit (NICU) FH Medical College Agra, a tertiary care center catering rural and urban population. Total 60 neonates admitted with history of birth asphyxia between January 2022 to June 2022 were enrolled. Neonates were classified into Hypoxic Ischaemic Encephalopathy (HIE) stage 1, 2 and 3 (according to Sarnat and Sarnat staging). Parameters such as Prothrombin Time (PT)/ International Normalised Ratio (INR) and platelet count was analysed. For describing continuous variables means and standard deviations and for comparison Analysis of Variance (ANOVA) test and Chi-square test were used. Results: In this study, total 60 neonates were enrolled. Out of these 43 (71.61%) were male and 17 (28.33%) female. Highest number of cases 34 (56.7%) were from HIE stage 3 followed by 22 (36.7%) HIE stage 2 and 4 (6.7%) from HIE stage 1. Among them 14 newborns with HIE stage 3 were died. PT and INR was significantly deranged in HIE stage 3 and 2 (p-value <0.05). HIE stage 3 has highest mortality and morbidity. Platelet count were normal in HIE stage 1 followed by decreased in HIE stage 2 and 3 and also statistically significant. Conclusion: Coagulation derangement is very common in babies with HIE and evident before clinical bleeding and this derangement is associated with poor outcome. Hence, timely intervention and appropriate management can improve the clinical outcome.
{"title":"Effect of Hypoxic Ischaemic Encephalopathy on Coagulation Profile in Neonates in a Tertiary Care Center, Agra- A Prospective Clinical Study","authors":"P. Mittal, S. Firoz, Digvijay Ghangas, S. Bhatt","doi":"10.7860/ijnmr/2023/60848.2380","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/60848.2380","url":null,"abstract":"Introduction: Perinatal asphyxia is very common in developing countries. Coagulopathy occurs as a part of spectrum of multiorgan dysfunction following hypoxic insult. In asphyxiated neonate, bleeding due to coagulation abnormality is common and potentially life threatening. There are very few studies done on coagulation profile with perinatal asphyxia in last few decades. Aim: To evaluate the coagulation profile in neonates with hypoxic ischaemic encephalopathy in a tertiary care center, Agra. Materials and Methods: This was a prospective clinical study undertaken in Neonatal Intensive Care Unit (NICU) FH Medical College Agra, a tertiary care center catering rural and urban population. Total 60 neonates admitted with history of birth asphyxia between January 2022 to June 2022 were enrolled. Neonates were classified into Hypoxic Ischaemic Encephalopathy (HIE) stage 1, 2 and 3 (according to Sarnat and Sarnat staging). Parameters such as Prothrombin Time (PT)/ International Normalised Ratio (INR) and platelet count was analysed. For describing continuous variables means and standard deviations and for comparison Analysis of Variance (ANOVA) test and Chi-square test were used. Results: In this study, total 60 neonates were enrolled. Out of these 43 (71.61%) were male and 17 (28.33%) female. Highest number of cases 34 (56.7%) were from HIE stage 3 followed by 22 (36.7%) HIE stage 2 and 4 (6.7%) from HIE stage 1. Among them 14 newborns with HIE stage 3 were died. PT and INR was significantly deranged in HIE stage 3 and 2 (p-value <0.05). HIE stage 3 has highest mortality and morbidity. Platelet count were normal in HIE stage 1 followed by decreased in HIE stage 2 and 3 and also statistically significant. Conclusion: Coagulation derangement is very common in babies with HIE and evident before clinical bleeding and this derangement is associated with poor outcome. Hence, timely intervention and appropriate management can improve the clinical outcome.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/60996.2371
K. Rajeswari, M. Geetha
Introduction: Dermatologic conditions constitute at least 30% of all outpatient visits to paediatricians and 30% of all visits to dermatologists involve children. Skin conditions that manifest themselves during childhood and adolescence are referred as paediatric dermatoses and make up their own unique category of skin conditions. Aim: To identify the dermatological conditions which were prevalent during the Coronavirus Disease 2019 (COVID-19) pandemic in a tertiary care hospital in Bangalore. Materials and Methods: This retrospective cross-sectional study was conducted by reviewing records of Outpatient Department (OPD) of Dermatology and Paediatrics in our tertiary care center, Bengaluru from February 2020 to February 2022. The demographic details and diagnosis are recorded. The diagnosis was made according to ICD-10 (International Classification of Diseases 10th Revision) and the prevalence of different dermatoses was calculated. Mean and standard deviation was calculated for descriptive statistics. Data were statistically evaluated with IBM Social Package for Statistical Analysis (SPSS) Statistics for Windows version 26.0., IBM Corp., Chicago, IL. Results: The total number of paediatric cases attended dermatology OPD during the two year pandemic was 558. The prevalence of paediatric dermatoses in the present study was 193 (34.58%). There were 283 girls and 275 boys with Male : Female is 1:1.02. There is a female preponderance of 50.7% against 49.28%. The majority was infectious lesions 153 (27.41%), congenital dermatoses 9 (1.61%), Papulosquamous disorders 23 (4.12%), Pilosebaceous disorders 111 (19.89%), dermatitis 193 (34.58%) followed by Miscellaneous 69 (12.36%). Conclusion: This study was conducted during COVID-19 pandemic which in comparison to the other studies shows a similar distribution of dermatoses. But there was a significant shift of age group affected which can be well explained by the lockdown and social isolation.
导读:皮肤科疾病占儿科医生门诊就诊的至少30%，皮肤科医生门诊就诊的30%涉及儿童。在儿童和青少年时期表现出来的皮肤病被称为儿科皮肤病，构成了他们自己独特的皮肤病类别。目的:确定班加罗尔一家三级医疗医院2019冠状病毒病(COVID-19)大流行期间流行的皮肤病。材料和方法:本回顾性横断面研究通过回顾我们班加罗尔三级保健中心2020年2月至2022年2月皮肤科和儿科门诊(OPD)的记录进行。记录人口统计细节和诊断。根据ICD-10(国际疾病分类第十版)进行诊断，并计算不同皮肤病的患病率。计算描述性统计的均值和标准差。使用IBM Social Package for Statistical Analysis (SPSS) Statistics for Windows version 26.0对数据进行统计评估。结果:在两年大流行期间，皮肤科门诊就诊的儿科病例总数为558例。本组儿童皮肤病患病率为193例(34.58%)。女生283人，男生275人，男女比例为1:1.02。女性占50.7%，女性占49.28%。其中感染性病变153例(27.41%)，先天性皮肤病9例(1.61%)，丘疹鳞状病变23例(4.12%)，皮脂腺病变111例(19.89%)，皮炎193例(34.58%)，其他69例(12.36%)次之。结论:本研究是在COVID-19大流行期间进行的，与其他研究相比，该研究显示了类似的皮肤病分布。但受影响的年龄组发生了重大变化，这可以用封锁和社会隔离来很好地解释。
{"title":"A Retrospective Cross-sectional Study of Paediatric Dermatoses during the COVID-19 Pandemic in a Tertiary Care Hospital in Bengaluru, Karnataka, India","authors":"K. Rajeswari, M. Geetha","doi":"10.7860/ijnmr/2023/60996.2371","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/60996.2371","url":null,"abstract":"Introduction: Dermatologic conditions constitute at least 30% of all outpatient visits to paediatricians and 30% of all visits to dermatologists involve children. Skin conditions that manifest themselves during childhood and adolescence are referred as paediatric dermatoses and make up their own unique category of skin conditions. Aim: To identify the dermatological conditions which were prevalent during the Coronavirus Disease 2019 (COVID-19) pandemic in a tertiary care hospital in Bangalore. Materials and Methods: This retrospective cross-sectional study was conducted by reviewing records of Outpatient Department (OPD) of Dermatology and Paediatrics in our tertiary care center, Bengaluru from February 2020 to February 2022. The demographic details and diagnosis are recorded. The diagnosis was made according to ICD-10 (International Classification of Diseases 10th Revision) and the prevalence of different dermatoses was calculated. Mean and standard deviation was calculated for descriptive statistics. Data were statistically evaluated with IBM Social Package for Statistical Analysis (SPSS) Statistics for Windows version 26.0., IBM Corp., Chicago, IL. Results: The total number of paediatric cases attended dermatology OPD during the two year pandemic was 558. The prevalence of paediatric dermatoses in the present study was 193 (34.58%). There were 283 girls and 275 boys with Male : Female is 1:1.02. There is a female preponderance of 50.7% against 49.28%. The majority was infectious lesions 153 (27.41%), congenital dermatoses 9 (1.61%), Papulosquamous disorders 23 (4.12%), Pilosebaceous disorders 111 (19.89%), dermatitis 193 (34.58%) followed by Miscellaneous 69 (12.36%). Conclusion: This study was conducted during COVID-19 pandemic which in comparison to the other studies shows a similar distribution of dermatoses. But there was a significant shift of age group affected which can be well explained by the lockdown and social isolation.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/57943.2369
B. K. Khuntdar, S. Mondal, S. Naik, M. P. Mohanta
Introduction: Neonatal seizures are common but can be manifestations of serious underlying disorders and sometimes have a grave prognosis. Predictors for adverse outcomes are important for early referral and advanced interventions. Aim: To study the incidence and factors associated with neonatal seizure and to determine the predictors of adverse outcomes. Materials and Methods: This was a longitudinal study, conducted from April 2020 to March 2021 at a Rural Medical College (Midnapore Medical College and Hospital, West Bengal) in Eastern India. All the admitted newborns (N=143) in the Special Newborn Care Unit (SNCU), who had clinically evident seizures, were included in the study. Data were collected regarding the perinatal history, gestational age, type of delivery, birth weight, APGAR score at 1 and 5 minutes, and need for resuscitation at birth. The onset of the seizure, seizure type, investigation findings, possible aetiological diagnosis, and final outcome was noted. The management of neonatal seizures was as per the institutional protocol. Babies were followed up for a minimum of 28 days or throughout their hospital stay till discharge/death. The outcome was categorised into two categories: ‘favourable’ when there was a normal neurological examination and ‘unfavourable’ when there was any neurological impairment or death. Statistical analyses were performed using the Statistical Package for Social Sciences software version 25 (SPSS Inc., Chicago, IL, USA). Risk factors were determined by analysing outcomes using simple and multivariate logistic regression analysis. The p-values less than 0.05 were considered as statistically significant. Results: A total of 143 newborns had seizures out of 3126, making the incidence of neonatal seizures 4.57%. Males outnumbered females. Total 64.33% were preterm. Five minutes APGAR score <7 was noticed in 44.75%. The most common type was subtle seizure. Advanced resuscitation manoeuvre was required for 46.8% cases whereas mechanical ventilation was required in 11.88%. The most common aetiology was birth asphyxia (46.15%), and the cranial ultrasound showed Hypoxic Ishchaemic Encephalopathy (HIE) changes in 30.77% of cases. Multiple logistic regressions revealed only four factors, namely, preterm delivery (OR 5.82), need for extensive resuscitation manoeuvre (OR 6.21), presence of status epilepticus (OR 3.49) and abnormal cranial ultrasound (OR 1.02) to be the independent risk factors for unfavourable outcome. Conclusion: Clinical diagnosis of neonatal seizure could be useful in resource poor centers, where video-Electroencephalogram (EEG) is not available. Premature delivery, need for extensive resuscitation, presence of status epilepticus and abnormal cranial ultrasound were associated with poor short-term outcome.
新生儿癫痫发作是常见的，但可能是严重的潜在疾病的表现，有时有严重的预后。不良后果的预测因素对早期转诊和晚期干预措施很重要。目的:研究新生儿癫痫发作的发生率及相关因素，确定不良结局的预测因素。材料和方法:这是一项纵向研究，于2020年4月至2021年3月在印度东部的一所农村医学院(Midnapore医学院和医院，西孟加拉邦)进行。所有在新生儿特护病房(SNCU)有临床明显癫痫发作的新生儿(N=143)纳入研究。收集围产期、胎龄、分娩类型、出生体重、1分钟和5分钟APGAR评分、出生时复苏需求等数据。记录了癫痫发作、发作类型、调查结果、可能的病因学诊断和最终结果。新生儿癫痫发作的管理是按照机构协议。对婴儿进行至少28天或整个住院期间的随访，直到出院/死亡。结果分为两类:当有正常的神经系统检查时为“有利”，当有任何神经损伤或死亡时为“不利”。使用Statistical Package for Social Sciences软件版本25 (SPSS Inc.， Chicago, IL, USA)进行统计分析。通过简单和多因素logistic回归分析结果确定危险因素。p值小于0.05认为有统计学意义。结果:3126例新生儿中癫痫发作143例，新生儿癫痫发作发生率为4.57%。男性多于女性。早产儿占64.33%。5分钟APGAR评分<7的占44.75%。最常见的类型是轻微癫痫发作。46.8%的患者需要进行高级复苏，11.88%的患者需要进行机械通气。最常见的病因是出生窒息(46.15%)，颅脑超声显示缺氧缺血性脑病(HIE)改变的占30.77%。多因素logistic回归分析显示，早产(OR 5.82)、需要广泛复苏操作(OR 6.21)、存在癫痫持续状态(OR 3.49)和颅超声异常(OR 1.02)四个因素是不利结果的独立危险因素。结论:新生儿癫痫的临床诊断在资源贫乏、没有视频脑电图(EEG)的地区是有用的。早产、需要广泛复苏、存在癫痫持续状态和颅超声异常与短期预后不良相关。
{"title":"Evaluation of Adverse Outcome Predictors in Neonatal Seizure: A Longitudinal Study from a Tertiary Centre of Eastern India","authors":"B. K. Khuntdar, S. Mondal, S. Naik, M. P. Mohanta","doi":"10.7860/ijnmr/2023/57943.2369","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/57943.2369","url":null,"abstract":"Introduction: Neonatal seizures are common but can be manifestations of serious underlying disorders and sometimes have a grave prognosis. Predictors for adverse outcomes are important for early referral and advanced interventions. Aim: To study the incidence and factors associated with neonatal seizure and to determine the predictors of adverse outcomes. Materials and Methods: This was a longitudinal study, conducted from April 2020 to March 2021 at a Rural Medical College (Midnapore Medical College and Hospital, West Bengal) in Eastern India. All the admitted newborns (N=143) in the Special Newborn Care Unit (SNCU), who had clinically evident seizures, were included in the study. Data were collected regarding the perinatal history, gestational age, type of delivery, birth weight, APGAR score at 1 and 5 minutes, and need for resuscitation at birth. The onset of the seizure, seizure type, investigation findings, possible aetiological diagnosis, and final outcome was noted. The management of neonatal seizures was as per the institutional protocol. Babies were followed up for a minimum of 28 days or throughout their hospital stay till discharge/death. The outcome was categorised into two categories: ‘favourable’ when there was a normal neurological examination and ‘unfavourable’ when there was any neurological impairment or death. Statistical analyses were performed using the Statistical Package for Social Sciences software version 25 (SPSS Inc., Chicago, IL, USA). Risk factors were determined by analysing outcomes using simple and multivariate logistic regression analysis. The p-values less than 0.05 were considered as statistically significant. Results: A total of 143 newborns had seizures out of 3126, making the incidence of neonatal seizures 4.57%. Males outnumbered females. Total 64.33% were preterm. Five minutes APGAR score <7 was noticed in 44.75%. The most common type was subtle seizure. Advanced resuscitation manoeuvre was required for 46.8% cases whereas mechanical ventilation was required in 11.88%. The most common aetiology was birth asphyxia (46.15%), and the cranial ultrasound showed Hypoxic Ishchaemic Encephalopathy (HIE) changes in 30.77% of cases. Multiple logistic regressions revealed only four factors, namely, preterm delivery (OR 5.82), need for extensive resuscitation manoeuvre (OR 6.21), presence of status epilepticus (OR 3.49) and abnormal cranial ultrasound (OR 1.02) to be the independent risk factors for unfavourable outcome. Conclusion: Clinical diagnosis of neonatal seizure could be useful in resource poor centers, where video-Electroencephalogram (EEG) is not available. Premature delivery, need for extensive resuscitation, presence of status epilepticus and abnormal cranial ultrasound were associated with poor short-term outcome.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes Mellitus (DM) is a chronic metabolic disorder characterised by insulin deficiency or resistance and/or β-cell defects. High Body Mass Index (BMI) at conception, undiagnosed pregestational diabetes, and poor glycaemic control significantly affect the foetal heart, foetoplacental circulation and foetal growth. Myocardial hypertrophy and cardiac defects are more prevalent in Infants of Diabetic Mothers (IDMs). Cardiac Hypertrophy (CH) is characterised by a significant thickening of the interventricular septum, reduction in the size of the ventricular cavity, systolic and diastolic dysfunction and subaortic stenosis. A term neonate born to a mother with pregestational insulin-dependent Type I Diabetes Mellitus (T1DM) developed respiratory distress soon after birth, and Echocardiography (ECHO) showed Asymmetric Septal Hypertrophy (ASH) and Left Ventricular Outflow Tract (LVOT) obstruction. The baby responded well to oral propranolol, which was continued for four weeks, resulting in the resolution of CH at four months of age on follow-up. The present case underscores the importance of ECHO, even in infants born to mothers with good glycaemic control.
{"title":"Cardiac Hypertrophy in an Infant of a Diabetic Mother: A Case of Reversible Cardiomyopathy","authors":"Basany Laxman, Naga Priyanka Gandrakota, Vinay Batthula, Rajesh Babu Gudipati","doi":"10.7860/ijnmr/2023/64417.2389","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/64417.2389","url":null,"abstract":"Diabetes Mellitus (DM) is a chronic metabolic disorder characterised by insulin deficiency or resistance and/or β-cell defects. High Body Mass Index (BMI) at conception, undiagnosed pregestational diabetes, and poor glycaemic control significantly affect the foetal heart, foetoplacental circulation and foetal growth. Myocardial hypertrophy and cardiac defects are more prevalent in Infants of Diabetic Mothers (IDMs). Cardiac Hypertrophy (CH) is characterised by a significant thickening of the interventricular septum, reduction in the size of the ventricular cavity, systolic and diastolic dysfunction and subaortic stenosis. A term neonate born to a mother with pregestational insulin-dependent Type I Diabetes Mellitus (T1DM) developed respiratory distress soon after birth, and Echocardiography (ECHO) showed Asymmetric Septal Hypertrophy (ASH) and Left Ventricular Outflow Tract (LVOT) obstruction. The baby responded well to oral propranolol, which was continued for four weeks, resulting in the resolution of CH at four months of age on follow-up. The present case underscores the importance of ECHO, even in infants born to mothers with good glycaemic control.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The demand for most micronutrients increases during pregnancy for obvious reasons. Micronutrients like copper and zinc are indispensable co-factors for various enzymes in metabolism. The reduction in the concentration of serum iron and ferritin is a common phenomenon in pregnancy, and early diagnosis is crucial for favourable maternal and foetal outcomes. However, there is a dearth of studies on the metabolism of micronutrients in pregnancy. Aim: The aim of this cross-sectional study, conducted from July 2018 to February 2019 in the Department of Gynaecology and Obstetrics and the Department of Biochemistry, College of Medicine and Sagore Dutta Hospital, West Bengal, India, was to assess the serum levels of copper, zinc, and iron in maternal serum and foetal cord blood. Additionally, the study aimed to correlate the concentrations of these micronutrients between maternal serum and foetal cord blood. Materials and Methods: A total of 336 pregnant women of childbearing age, irrespective of gravida, were included in the study. Blood samples were collected from the pregnant women, and cord blood samples were collected from the foetal end in clot vials for the estimation of copper, zinc, and iron levels. Correlation was assessed between the concentration of these micronutrients in maternal serum and cord blood of the newborn. Data normality was determined using the Shapiro-Wilk normality tests, and the significance level was set at p-value ≤0.05. Results: The study included a total of 336 pregnant women in the age group of 18-33 years, with a mean age of 29.72±4.39 years. In maternal serum, the mean concentration of copper was 122.79±33.67 μg/dL, zinc was 78.47±27.62 μg/dL, and iron was 114.5±45.05 μg/dL. In foetal cord blood, the mean concentration of copper was 48.02±16.37 μg/dL, zinc was 75.82±27.64 μg/dL, and iron was 185.30±52.74 μg/dL. The correlation coefficients between maternal serum and foetal cord blood concentrations were statistically significant for zinc and iron (p-value<0.05). Additionally, the correlation was statistically significant for copper (p-value=0.030). The mean concentration of haemoglobin in maternal serum was 10.9±1.96 g/dL, compared to 14.05±2.13 g/dL in cord blood. The mean maternal serum ferritin was 73.53±56.15 μg/L, and the mean cord blood ferritin was 147.21±61.13 μg/L. Conclusion: The study demonstrated a positive correlation between the concentrations of iron and zinc in maternal serum and foetal cord blood, while a negative correlation was observed for copper concentration.
{"title":"Correlation between Selected Micronutrient Status in Maternal Blood and Cord Blood of Newborn from a Tertiary Care Hospital in West Bengal, India: A Cross-sectional Study","authors":"Sanjoy Kumar Kunti, Sharmistha Chatterjee, Indranil Chakraborty","doi":"10.7860/ijnmr/2023/60771.2390","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/60771.2390","url":null,"abstract":"Introduction: The demand for most micronutrients increases during pregnancy for obvious reasons. Micronutrients like copper and zinc are indispensable co-factors for various enzymes in metabolism. The reduction in the concentration of serum iron and ferritin is a common phenomenon in pregnancy, and early diagnosis is crucial for favourable maternal and foetal outcomes. However, there is a dearth of studies on the metabolism of micronutrients in pregnancy. Aim: The aim of this cross-sectional study, conducted from July 2018 to February 2019 in the Department of Gynaecology and Obstetrics and the Department of Biochemistry, College of Medicine and Sagore Dutta Hospital, West Bengal, India, was to assess the serum levels of copper, zinc, and iron in maternal serum and foetal cord blood. Additionally, the study aimed to correlate the concentrations of these micronutrients between maternal serum and foetal cord blood. Materials and Methods: A total of 336 pregnant women of childbearing age, irrespective of gravida, were included in the study. Blood samples were collected from the pregnant women, and cord blood samples were collected from the foetal end in clot vials for the estimation of copper, zinc, and iron levels. Correlation was assessed between the concentration of these micronutrients in maternal serum and cord blood of the newborn. Data normality was determined using the Shapiro-Wilk normality tests, and the significance level was set at p-value ≤0.05. Results: The study included a total of 336 pregnant women in the age group of 18-33 years, with a mean age of 29.72±4.39 years. In maternal serum, the mean concentration of copper was 122.79±33.67 μg/dL, zinc was 78.47±27.62 μg/dL, and iron was 114.5±45.05 μg/dL. In foetal cord blood, the mean concentration of copper was 48.02±16.37 μg/dL, zinc was 75.82±27.64 μg/dL, and iron was 185.30±52.74 μg/dL. The correlation coefficients between maternal serum and foetal cord blood concentrations were statistically significant for zinc and iron (p-value<0.05). Additionally, the correlation was statistically significant for copper (p-value=0.030). The mean concentration of haemoglobin in maternal serum was 10.9±1.96 g/dL, compared to 14.05±2.13 g/dL in cord blood. The mean maternal serum ferritin was 73.53±56.15 μg/L, and the mean cord blood ferritin was 147.21±61.13 μg/L. Conclusion: The study demonstrated a positive correlation between the concentrations of iron and zinc in maternal serum and foetal cord blood, while a negative correlation was observed for copper concentration.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136208890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/58624.2378
Jayashri Chandrakant Sawale, L. Dhande, Pooja Bhimashankar Nagrale
Introduction: Birth weight is a very important determinant factor regarding perinatal morbidity and mortality. However, in developing countries like India weighing facility may not be available in rural areas where an alternative anthropometric parameter like Mid Upper Arm Circumference (MUAC) may be considered alternative to birth weight. Aim: To determine the accuracy of MUAC by comparing it with different anthropometric parameters for identification of LBW in neonates within the first 24 hours of life. Materials and Methods: The present study was a hospital based cross-sectional study conducted in labour ward, Postnatal Care (PNC) wards and Neonatal Intensive Care Unit (NICU) of Indira Gandhi Medical College, Nagpur. Total 640 babies were enrolled over a period of 2 years from September 2018 to September 2020. Anthropometric parameters like weight, length, head circumference, Chest Circumference (CC), MUAC, ponderal index were taken by a researcher using standard techniques within first 24 hours of life and correlated with birth weight by using Pearson’s correlation coefficient. The comparison of the quantitative and qualitative variables was analysed using independent t-test and chi-square test, respectively. Receiver Operating Characteristic (ROC) curve was used to find out cut- off point of anthropometric parameters for predicting birth weight (<2000 gm, <1500 gm, <1000 gm). DeLong test was used for comparison of area under curve between different anthropometric parameters for predicting birth weight (<2000 gm, <1500 gm, <1000 gm). Univariate linear regression was used to assess the effect of anthropometric parameters on birth weight. The data entry was done in the Microsoft EXCEL spreadsheet and final analysis was done with the use of Statistical Package for Social Sciences (SPSS) software version 21.0. Results: Among 640 newborns, 334 (59.19%) were females and 306 (47.81%) were males. The mean birth weight was 1903.93 grams and MUAC of 8.3cm. All the chosen parameters showed significant correlation with birth weight (p<0.001). However, MUAC showed strongest correlation (r=0.890) with birth weight and easy to measure. Cut-offs of MUAC ≤8.45 cm, ≤7.5 cm, ≤6.8 cm predict birth weight of <2000gm, <1500gm, <1000gm with sensitivity of 91.22%, 92.81%, 100% and specificity of 88.95%, 89.12%, 89.35%, respectively. Conclusion: MUAC is the most simple and best surrogate measure that can be used in domiciliary outreach when it is impossible to record weight of baby at birth.
{"title":"Mid Upper Arm Circumference as the Best Surrogate Marker for Identification of Low Birth Weight in Newborns within the First 24 Hours of Life- A Cross-sectional Study","authors":"Jayashri Chandrakant Sawale, L. Dhande, Pooja Bhimashankar Nagrale","doi":"10.7860/ijnmr/2023/58624.2378","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/58624.2378","url":null,"abstract":"Introduction: Birth weight is a very important determinant factor regarding perinatal morbidity and mortality. However, in developing countries like India weighing facility may not be available in rural areas where an alternative anthropometric parameter like Mid Upper Arm Circumference (MUAC) may be considered alternative to birth weight. Aim: To determine the accuracy of MUAC by comparing it with different anthropometric parameters for identification of LBW in neonates within the first 24 hours of life. Materials and Methods: The present study was a hospital based cross-sectional study conducted in labour ward, Postnatal Care (PNC) wards and Neonatal Intensive Care Unit (NICU) of Indira Gandhi Medical College, Nagpur. Total 640 babies were enrolled over a period of 2 years from September 2018 to September 2020. Anthropometric parameters like weight, length, head circumference, Chest Circumference (CC), MUAC, ponderal index were taken by a researcher using standard techniques within first 24 hours of life and correlated with birth weight by using Pearson’s correlation coefficient. The comparison of the quantitative and qualitative variables was analysed using independent t-test and chi-square test, respectively. Receiver Operating Characteristic (ROC) curve was used to find out cut- off point of anthropometric parameters for predicting birth weight (<2000 gm, <1500 gm, <1000 gm). DeLong test was used for comparison of area under curve between different anthropometric parameters for predicting birth weight (<2000 gm, <1500 gm, <1000 gm). Univariate linear regression was used to assess the effect of anthropometric parameters on birth weight. The data entry was done in the Microsoft EXCEL spreadsheet and final analysis was done with the use of Statistical Package for Social Sciences (SPSS) software version 21.0. Results: Among 640 newborns, 334 (59.19%) were females and 306 (47.81%) were males. The mean birth weight was 1903.93 grams and MUAC of 8.3cm. All the chosen parameters showed significant correlation with birth weight (p<0.001). However, MUAC showed strongest correlation (r=0.890) with birth weight and easy to measure. Cut-offs of MUAC ≤8.45 cm, ≤7.5 cm, ≤6.8 cm predict birth weight of <2000gm, <1500gm, <1000gm with sensitivity of 91.22%, 92.81%, 100% and specificity of 88.95%, 89.12%, 89.35%, respectively. Conclusion: MUAC is the most simple and best surrogate measure that can be used in domiciliary outreach when it is impossible to record weight of baby at birth.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/59688.2383
Sinchana G. Bhat, G. Shreekrishna, G. Shwetha
Introduction: Respiratory Distress Syndrome (RDS) is one of the most common conditions leading to significant morbidity and mortality. Early diagnosis with a non-invasive imaging tool such as ultrasound, with no radiation hazard will be beneficial for timely intervention in neonates. Aim: To evaluate the utility of Lung Ultrasound (LUS) in diagnosing RDS in neonates and to compare it with chest X-ray (CXR). Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital in Department of Pediatrics, AJ Institute of Medical Sciences, Mangalore, Karnataka, India, from June 2017 to December 2018. Forty neonates (preterm and term) admitted to Neonatal Intensive Care Unit (NICU) with symptoms of respiratory distress within six hours of life and fulfilling clinical criteria of RDS were included in the study. CXR and LUS were performed and interpreted by the same radiologist. The disease was graded as mild and severe by LUS based on the indices like B (Beam like comet-tail pattern) lines, alveolar consolidation, air bronchogram and white lung and it was compared with CXR in terms of sensitivity and specificity to diagnose RDS. Data were statistically analysed using Kendall’s tau-b test. Results: Eighteen (45%) neonates were <32 weeks, 19 (47%), between 32-34 weeks and 3 (7.5%) were >34 weeks of gestation. Twenty-six (65%) were males and 14 (35%) were females. Mean gestational age of the study cohort was 32±2 weeks. Mean birth weight in the study group was 1.7±0.5 kg. 14 out of the 40 neonates (65%) received steroids prior to delivery. LUS detected signs of RDS in all the 40 cases (100% sensitivity). Sixteen out of 40 (40%) neonates were graded as mild RDS and 24 out of 40 neonates (60%) as severe RDS. The sensitivity to detect severe cases was 100% when compared to CXR but specificity to detect mild cases was found to be 59%. The Positive Predictability Value (PPV) was found to be 54% and the Negative Predictable Value (NPV) was found to be 100%. Conclusion: LUS can be used as a reliable, bed side screening tool for the early diagnosis of RDS in NICU without side-effects of radiation.
{"title":"Utility of Lung Ultrasound in Diagnosis of Respiratory Distress Syndrome in Neonates: A Cross-sectional Study","authors":"Sinchana G. Bhat, G. Shreekrishna, G. Shwetha","doi":"10.7860/ijnmr/2023/59688.2383","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/59688.2383","url":null,"abstract":"Introduction: Respiratory Distress Syndrome (RDS) is one of the most common conditions leading to significant morbidity and mortality. Early diagnosis with a non-invasive imaging tool such as ultrasound, with no radiation hazard will be beneficial for timely intervention in neonates. Aim: To evaluate the utility of Lung Ultrasound (LUS) in diagnosing RDS in neonates and to compare it with chest X-ray (CXR). Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital in Department of Pediatrics, AJ Institute of Medical Sciences, Mangalore, Karnataka, India, from June 2017 to December 2018. Forty neonates (preterm and term) admitted to Neonatal Intensive Care Unit (NICU) with symptoms of respiratory distress within six hours of life and fulfilling clinical criteria of RDS were included in the study. CXR and LUS were performed and interpreted by the same radiologist. The disease was graded as mild and severe by LUS based on the indices like B (Beam like comet-tail pattern) lines, alveolar consolidation, air bronchogram and white lung and it was compared with CXR in terms of sensitivity and specificity to diagnose RDS. Data were statistically analysed using Kendall’s tau-b test. Results: Eighteen (45%) neonates were <32 weeks, 19 (47%), between 32-34 weeks and 3 (7.5%) were >34 weeks of gestation. Twenty-six (65%) were males and 14 (35%) were females. Mean gestational age of the study cohort was 32±2 weeks. Mean birth weight in the study group was 1.7±0.5 kg. 14 out of the 40 neonates (65%) received steroids prior to delivery. LUS detected signs of RDS in all the 40 cases (100% sensitivity). Sixteen out of 40 (40%) neonates were graded as mild RDS and 24 out of 40 neonates (60%) as severe RDS. The sensitivity to detect severe cases was 100% when compared to CXR but specificity to detect mild cases was found to be 59%. The Positive Predictability Value (PPV) was found to be 54% and the Negative Predictable Value (NPV) was found to be 100%. Conclusion: LUS can be used as a reliable, bed side screening tool for the early diagnosis of RDS in NICU without side-effects of radiation.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/62525.2379
Ashwini Sankannavar, M. Soumya, B. Masali
Introduction: The incidence of hypertension among neonates admitted to the Neonatal Intensive Care Unit (NICU) is increasing. The reported incidence is between 0.2% and 3%. Blood Pressure (BP) among neonates varies considerably in the immediate postnatal period. The BP in neonates determined by birthweight, gestational age at birth and postnatal age. This variability in BP makes it challenging to diagnose neonatal hypertension. There is a paucity of Indian studies on neonatal hypertension. A systematic diagnostic evaluation of neonatal hypertension aids in early identification of the aetiology and further management. Aim: To assess the incidence of hypertension in neonates in the NICU and to evaluate the aetiology and clinical profile of neonatal hypertension. Materials and Methods: This was a hospital-based prospective observational study done at Sri Dharmasthala Manjunatheswara College of Medical Sciences and Hospital, Dharwad, Karnataka, India, between August 2016 and August 2021. A total of 29 neonates who had neonatal hypertension were included in the study after obtaining ethical committee clearance. All relevant data regarding demographic details, risk factors for hypertension, clinical features, probable aetiology, and relevant investigations were collected in a predesigned proforma. These neonates were followed- up once a month until six months of age. All the data were entered in Microsoft Excel version 2203 and analysed using the Statistical Package for Social Sciences (SPSS) software version 20.0. The categorical variables were described as percentages. The numerical variables were compared using a Student’s t-test and a Chi-square test. A p-value of 0.05 was considered statistically significant. Results: In the present study, out of 13,345, a total of 29 (0.22%) neonates had hypertension. Hypertension was more prevalent among term (82.7%). Of the 29 neonates, 19 (65.5%) had an antenatal risk for hypertension. A total of 14 (48.3%) of neonates had an antenatally diagnosed renal and/or cardiac anomaly. The most common presentation of hypertension is asymptomatic. Thirteen (44.8%) neonates had transient hypertension, which resolved at the time of discharge, and 16 (55.2%) neonates had persistent hypertension, requiring antihypertensive medication and follow-up. The most common aetiology for hypertension was renal and renovascular causes (44.8%). Mortality in the present study was 10.3% (n=3). Conclusion: Hypertension is an uncommon yet important problem in the NICU. In the majority of neonates, the presentation of hypertension is asymptomatic. Most common aetiology of hypertension being renal cause. Neonates with persistent hypertension may require long-term antihypertensive treatment and regular follow-up.
{"title":"Clinico-aetiological Profile of Neonatal Hypertension: An Observational Study","authors":"Ashwini Sankannavar, M. Soumya, B. Masali","doi":"10.7860/ijnmr/2023/62525.2379","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/62525.2379","url":null,"abstract":"Introduction: The incidence of hypertension among neonates admitted to the Neonatal Intensive Care Unit (NICU) is increasing. The reported incidence is between 0.2% and 3%. Blood Pressure (BP) among neonates varies considerably in the immediate postnatal period. The BP in neonates determined by birthweight, gestational age at birth and postnatal age. This variability in BP makes it challenging to diagnose neonatal hypertension. There is a paucity of Indian studies on neonatal hypertension. A systematic diagnostic evaluation of neonatal hypertension aids in early identification of the aetiology and further management. Aim: To assess the incidence of hypertension in neonates in the NICU and to evaluate the aetiology and clinical profile of neonatal hypertension. Materials and Methods: This was a hospital-based prospective observational study done at Sri Dharmasthala Manjunatheswara College of Medical Sciences and Hospital, Dharwad, Karnataka, India, between August 2016 and August 2021. A total of 29 neonates who had neonatal hypertension were included in the study after obtaining ethical committee clearance. All relevant data regarding demographic details, risk factors for hypertension, clinical features, probable aetiology, and relevant investigations were collected in a predesigned proforma. These neonates were followed- up once a month until six months of age. All the data were entered in Microsoft Excel version 2203 and analysed using the Statistical Package for Social Sciences (SPSS) software version 20.0. The categorical variables were described as percentages. The numerical variables were compared using a Student’s t-test and a Chi-square test. A p-value of 0.05 was considered statistically significant. Results: In the present study, out of 13,345, a total of 29 (0.22%) neonates had hypertension. Hypertension was more prevalent among term (82.7%). Of the 29 neonates, 19 (65.5%) had an antenatal risk for hypertension. A total of 14 (48.3%) of neonates had an antenatally diagnosed renal and/or cardiac anomaly. The most common presentation of hypertension is asymptomatic. Thirteen (44.8%) neonates had transient hypertension, which resolved at the time of discharge, and 16 (55.2%) neonates had persistent hypertension, requiring antihypertensive medication and follow-up. The most common aetiology for hypertension was renal and renovascular causes (44.8%). Mortality in the present study was 10.3% (n=3). Conclusion: Hypertension is an uncommon yet important problem in the NICU. In the majority of neonates, the presentation of hypertension is asymptomatic. Most common aetiology of hypertension being renal cause. Neonates with persistent hypertension may require long-term antihypertensive treatment and regular follow-up.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/61049.2385
K. Haridas, Manikumar Solaippan, Ramya S. Shanmugam, Muthukumaran Natarajan
Introduction: The proportion of preterm babies is increasing now a days and these babies are more prone to short and long term disabilities. Hence, growth monitoring is essential, to identify the premature infants, who are at increased risk of growth lag and poor neurodevelopmental outcomes. Aim: To assess the growth pattern of infants, who are born ≤34 weeks of gestational age using the intergrowth-21st growth charts. Materials and Methods: This retrospective study was conducted in the Department of Neonatology at Chengalpattu Medical College and Hospital, a Tertiary Care Center Chengalpattu, Tamil Nadu, India. The duration of the study was one year, from January 2020 to December 2020. A total of 118 neonates born at ≤34 weeks gestational age, who were admitted in the hospital and stayed for 14 days and more were included in the study. The data was collected from discharge sheets and an electronic database. Intergrowth-21st growth charts are used to assess growth. Weight, duration of hospital stay and Extrauterine Growth Restriction (EUGR) were assessed for all the newborns. At discharge, the EUGR status of the babies was determined using a weight ≤-1.28 Standard Deviation (SD) criterion. Continuous variables were presented as means with SD. The data was analysed using Statistical Package for Social Sciences (SPSS) version 24.0. Results: The mean maternal and gestational age of the study participants was 24.9±4.14 years and 31.6 ±1.42 weeks and birth weight of babies were 1608.06 gm (±275), respectively. The proportions of Appropriate for gestational age (AGA) and Small For Gestational Age (SGA) were 95 (80.5%) and 18 (15.2%), respectively. The mean time to reach full feeds was 10.4 days (±2.7days), and the duration of stay in the hospital was 24.8 days (±9.6 days). The mean discharge weight and gestational age of babies were 1732 gm (±226 gm) and 35.4 weeks (±1.47 weeks), respectively. The common complications observed, were those requiring antibiotics (73.7%), respiratory support (61.01%), and Respiratory Distress Syndrome (RDS) (22.8%). Conclusion: Preterm newborns are more vulnerable to EUGR. The EUGR proportion in present study was 72.8%. The issues that raise the risk of EUGR, during the hospital stay must be adequately addressed in order to ensure that, preterm neonates develops normally.
{"title":"Growth Pattern of Preterm Newborns under 34 Weeks of Gestation in a Tertiary Care Hospital, Tamil Nadu, India: A Retrospective Study","authors":"K. Haridas, Manikumar Solaippan, Ramya S. Shanmugam, Muthukumaran Natarajan","doi":"10.7860/ijnmr/2023/61049.2385","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/61049.2385","url":null,"abstract":"Introduction: The proportion of preterm babies is increasing now a days and these babies are more prone to short and long term disabilities. Hence, growth monitoring is essential, to identify the premature infants, who are at increased risk of growth lag and poor neurodevelopmental outcomes. Aim: To assess the growth pattern of infants, who are born ≤34 weeks of gestational age using the intergrowth-21st growth charts. Materials and Methods: This retrospective study was conducted in the Department of Neonatology at Chengalpattu Medical College and Hospital, a Tertiary Care Center Chengalpattu, Tamil Nadu, India. The duration of the study was one year, from January 2020 to December 2020. A total of 118 neonates born at ≤34 weeks gestational age, who were admitted in the hospital and stayed for 14 days and more were included in the study. The data was collected from discharge sheets and an electronic database. Intergrowth-21st growth charts are used to assess growth. Weight, duration of hospital stay and Extrauterine Growth Restriction (EUGR) were assessed for all the newborns. At discharge, the EUGR status of the babies was determined using a weight ≤-1.28 Standard Deviation (SD) criterion. Continuous variables were presented as means with SD. The data was analysed using Statistical Package for Social Sciences (SPSS) version 24.0. Results: The mean maternal and gestational age of the study participants was 24.9±4.14 years and 31.6 ±1.42 weeks and birth weight of babies were 1608.06 gm (±275), respectively. The proportions of Appropriate for gestational age (AGA) and Small For Gestational Age (SGA) were 95 (80.5%) and 18 (15.2%), respectively. The mean time to reach full feeds was 10.4 days (±2.7days), and the duration of stay in the hospital was 24.8 days (±9.6 days). The mean discharge weight and gestational age of babies were 1732 gm (±226 gm) and 35.4 weeks (±1.47 weeks), respectively. The common complications observed, were those requiring antibiotics (73.7%), respiratory support (61.01%), and Respiratory Distress Syndrome (RDS) (22.8%). Conclusion: Preterm newborns are more vulnerable to EUGR. The EUGR proportion in present study was 72.8%. The issues that raise the risk of EUGR, during the hospital stay must be adequately addressed in order to ensure that, preterm neonates develops normally.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/57574.2376
Dheeraj Bahl, Varun Alwadhi, Parasdeep Kaur, H. Mittal
Introduction: Coronavirus Disease-2019 (COVID-19) pandemic was a global emergency in 2019 with multiphasic national lockdowns in most countries. Poor accessibility to travel and disease scare led to major fall in routine children vaccination. Aim: To study the impact of COVID-19 pandemic on routine children immunisation at a tertiary care centre in New Delhi, India. Materials and Methods: This retrospective cross-sectional study was carried out in May and June 2022, by collecting retrospective data from Immunisation Clinic of Paediatric Department of Dr. Ram Manohar Lohia hospital, a tertiary care public hospital from January 2018 to December 2021. The data of routine immunisation was further analysed to know the impact of the COVID-19 pandemic in children from birth to 5 years of age in 2019 i.e., before the lockdown versus the first and second major waves of COVID-19 in 2020 and 2021, respectively. The data was entered in an excel chart and statistical testing was conducted with Statistical Package for the Social Sciences (SPSS) version 27.0. Unpaired t-test of equal variance was used for data analysis and p <0.05 was considered as statistically significant. Results: There was a sharp fall in children receiving routine immunisation during COVID-19 pandemic in 2020(30.5%) and 2021 (24.9%) as compared to PreCOVID-19 period (2019). The overall vaccination coverage was significantly lower (p<0.001) in postlockdown-1 phase (July/Aug 2020; n=521) and postlockdown-2 phase (July/Aug 2021; n=735) in comparison to pre COVID-19 period (July/Aug 2019; n=899). Significant fall in vaccination (p<0.05) was seen in postlockdown phase 1 for birth dose vaccines, primary doses of combination vaccines, Measles-Rubella (MR-1) vaccine 1st dose, MR-2 and booster doses of Diphtheria, Pertussis, Tetanus (DPT) and for primary doses of combination vaccines, MR-1 vaccine 1st dose, MR-2 for postlockdown phase 2 (p<0.05). Conclusion: Routine immunisation for all vaccines had a major setback during unlockdown period in 2020 and 2021. There is an urge for national drive for routine Vaccine Preventable Diseases (VPD) to prevent their re-surgence.
{"title":"Impact of COVID-19 Pandemic on Routine Children Immunisation: Experience from a Tertiary Care Centre, in New Delhi, India","authors":"Dheeraj Bahl, Varun Alwadhi, Parasdeep Kaur, H. Mittal","doi":"10.7860/ijnmr/2023/57574.2376","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/57574.2376","url":null,"abstract":"Introduction: Coronavirus Disease-2019 (COVID-19) pandemic was a global emergency in 2019 with multiphasic national lockdowns in most countries. Poor accessibility to travel and disease scare led to major fall in routine children vaccination. Aim: To study the impact of COVID-19 pandemic on routine children immunisation at a tertiary care centre in New Delhi, India. Materials and Methods: This retrospective cross-sectional study was carried out in May and June 2022, by collecting retrospective data from Immunisation Clinic of Paediatric Department of Dr. Ram Manohar Lohia hospital, a tertiary care public hospital from January 2018 to December 2021. The data of routine immunisation was further analysed to know the impact of the COVID-19 pandemic in children from birth to 5 years of age in 2019 i.e., before the lockdown versus the first and second major waves of COVID-19 in 2020 and 2021, respectively. The data was entered in an excel chart and statistical testing was conducted with Statistical Package for the Social Sciences (SPSS) version 27.0. Unpaired t-test of equal variance was used for data analysis and p <0.05 was considered as statistically significant. Results: There was a sharp fall in children receiving routine immunisation during COVID-19 pandemic in 2020(30.5%) and 2021 (24.9%) as compared to PreCOVID-19 period (2019). The overall vaccination coverage was significantly lower (p<0.001) in postlockdown-1 phase (July/Aug 2020; n=521) and postlockdown-2 phase (July/Aug 2021; n=735) in comparison to pre COVID-19 period (July/Aug 2019; n=899). Significant fall in vaccination (p<0.05) was seen in postlockdown phase 1 for birth dose vaccines, primary doses of combination vaccines, Measles-Rubella (MR-1) vaccine 1st dose, MR-2 and booster doses of Diphtheria, Pertussis, Tetanus (DPT) and for primary doses of combination vaccines, MR-1 vaccine 1st dose, MR-2 for postlockdown phase 2 (p<0.05). Conclusion: Routine immunisation for all vaccines had a major setback during unlockdown period in 2020 and 2021. There is an urge for national drive for routine Vaccine Preventable Diseases (VPD) to prevent their re-surgence.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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